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SPRING 2013
T h e Spirog ram
!
Pulmonary Hypertension
Sanjiva Lutchmedial , M.D.
Pulmonary hypertension is a rare CONTRIBUTORS
SANJIVA LUTCHMEDIAL, MD
DAVID KAMINSKY, MD
DAVID CHAPMAN, PHD
RESEARCH
COORDINATORS
STEPHANIE BURNS
SANDRA DIEHL
JOAN LIPPMANN
PATTI LUTTON
MEENA SUBRAMANIAN
INSIDE THIS
ISSUE:
Pulmonary Hypertension
1
World Lung Health Day
2
Ongoing Studies
3
New Asthma Study
4
lung disorder in which the arteries that carry blood from the heart to the lungs become narrow, making it dif9icult for blood to 9low through the vessels. As a result the pressure in these arteries rise far above normal levels which strains the right ventricle of the heart causing it to lose its ability to pump blood through the lung. This results in right heart failure. Symptoms of pulmonary hypertension usually do not occur until the condition has progressed substantially. The 9irst symptom is usually shortness of breath with everyday activity, such as climbing stairs. Chest pain and fainting spells may also occur. Because pulmonary hypertension may be caused by many medical conditions, a complete history and physical examination are necessary to rule out other diseases. Further tests may include blood tests, an echocardiogram and lung function test, which are needed to con9irm the diagnosis. Treatment varies per individual based on the different underlying causes, but generally includes taking medications, making lifestyle changes and surgery if necessary. Where in the past doctors had very little to offer in terms of treatment options, this has changed dramatically in recent years. Currently at the Vermont Lung Center we are conducting a clinical research study to help us understand more about the changes in the lung that occur with pulmonary hypertension. We are interested in determining whether a simple lung function test, the DLCO, can be used to follow and monitor patients with pulmonary hypertension undergoing treatment. The Vermont Lung Center participated in
the May 1 rally held on the lawn of the
Capital Building in Montpelier sponsored
by the Vermont Workers Center. The VLC
was there to offer pulmonary function
testing as part of free community health
screenings
WWW.VERMONTLUNG.ORG
SPRING 2013
World Lung Health Day:
Changing the Tide of Lung
Disease
During World Lung Health Day on
June 12, 2013, the Vermont Lung Center
will join Institutes around the world in
offering free lung function testing. So why
should you have your lung function tested?
The main role of the lung is to transport
oxygen from the environment into the
blood stream and transport carbon dioxide
from the blood back out. It’s not surprising
that how effective the lung functions in
transporting air becomes a major
indication of the presence of disease.
However, lung function testing is often
underutilized and therefore lung disease
remains vastly under recognized. It is not
uncommon to find that spirometry
uncovers nearly 20% of people with some
degree of lung abnormality, which is
usually related to chronic obstructive lung
disease or asthma. Although chronic
obstructive lung disease is largely
preventable, it remains the 3rd leading
cause of death in the US, in large part due
to under diagnosis of the disease. We hope
to begin to reverse this trend by offering
free lung function testing during World
Lung Health Day.
Both chronic obstructive lung disease
and asthma can lead to narrow airways
which reduce the speed at which you can
blow air out of your lungs. We can
measure this by simple blowing out tests,
known as spirometry. The most common
spirometry test measures the amount of
air you can blow out in one second, called
the “Forced Expiratory Volume in one
second” or FEV1. Although FEV1 differs
widely between people, once we take into
account your height, age and sex, we can
tell how well your lung functions
compared to if you had “healthy” lungs.
Although chronic obstructive lung
disease is predominantly due to the effects
of tobacco smoke a less common cause is
related to genetics. In most people, the
enzyme alpha-1 antitrysin protects the
lung from damage; however, some people
have a deficiency in alpha-1 antitrysin
which leads to lung disease similar to that
caused by smoking. It is estimated that up
to 3% of patients with COPD may have
undetected AAT deficiency. The World
Health Organization, American Thoracic
Society and European Respiratory Society
recommend that all patients with chronic
obstructive lung disease be tested for AAT
deficiency. This can be done by a simple
fingerstick blood test. As part of World
Lung Health Day, the Vermont Lung
Center, with the support of the Alpha 1
Foundation, will also be offering free blood
testing for AAT deficiency. Look for us
at the Davis Center Concourse from
10:00-2:00 on June 12th.
The tests are simple and the
experts are waiting, so why not
join the Vermont Lung Center
for World Lung Health Day!
David Chapman, PhD
David Kaminsky, MD
INTERESTED IN
VOLUNTEERING?
Things to know.:
1) The Vermont Lung Center
staff is responsible for making
sure you know what is expected
of you in regards to the study.
2) Once the study is explained
to you, you will be asked to
read and sign an“Informed
Consent”. This form is designed
to explain everything you need
to know about the study.
3) Studies may be therapeutic
(involving observation of lung
function). However The
Vermont Lung Center can make
no claims that your involvement
in a research study will improve
your condition.
4) Compensation may or may
not be provided to you for your
involvement in a study. If
compensation is provided, it is
meant to cover your time and
expenses incurred-it does not
constitute employment.
If you are interested in finding
out more about volunteering for
a research study, please call us
at
(802) 847-2193
WWW.VERMONTLUNG.ORG
ONGOING STUDIES AT THE VERMONT LUNG CENTER
ASTHMA
Asthma Patient Registry (APR)
Primary Investigator: Charles Irvin, Ph.D., Director, VLC
Coordinator: Kathleen Dwinell
Who: Anyone with a physician diagnosis of asthma
What: 1 visit lasting approximately 30 minutes
Compensation: none
LASST (Long-acting Beta Agonist Step Down Study
Primary Investigator: Charles Irvin, Ph.D., Director, VLC
Coordinator: Stephanie Burns
Who: Asthmatics ages 12 and older
What: 11 visits
Compensation: $75 per visit
SAPS (Smoking Asthmatics Cohort Study)
Primary Investigator: Charles Irvin, Ph.D., Director, VLC
Coordinator: Stephanie Burns
Who: Asthmatics ages 18 to 50 who smoke
What: 2 visits
Compensation: up to $175
CPAP (Effect of Positive Airway Pressure on Airway
Reactivity in Patients with Asthma)
Primary Investigator: Charles Irvin, Ph.D., Director, VLC
Coordinator: Stephanie Burns
Who: Asthmatics ages 15-60
What: 6 visits
Compensation: up to $600
Epithelial Duox1, IL-33, and Allergic Inflammation
Primary Investigator: Anne Dixon, M.D.
Coordinator: Joan Lippmann
Who: Asthmatics and Non-Asthmatics ages 18 and older
What: 1 visit
Compensation: $25
Assessing the Effects of Lung Volume and Time on Airway
Responsiveness in Asthmatic Subjects
Primary Investigator: Jason Bates, Ph.D.
Coordinator: Stephanie Burns
Who: Asthmatics and Non-Asthmatics ages 18 and older
What: 3 visits
Compensation: $25 per visit
ACIA: Non-invasive Detention of Airway Injury Associated
with Airway Closure in Asthmatic Subjects
Primary Investigator: David Kaminsky, M.D.
Coordinator: Meena Subramanian
Who: Moderate to Severe Asthmatics ages 18 and older
What: 5 visits
Compensation: up to $100
Study of Changes in Allergic Inflammation and Airway
Remodeling During Bariatric Surgery
Primary Investigator: Anne Dixon, M.D.
Coordinator: Stephanie Burns
Who: Asthmatics ages 18 and older having bariatric surgery
What: 2 visits
Compensation: $25 per visit
Effects of Obesity on Allergic Airway Inflammation
Primary Investigator: Anne Dixon, M.D.
Coordinator: Meena Subramanian
Who: Asthmatics ages 18 or older allergic to dust mites
What: 2 visits
Compensation: up to $200
SPRING 2013
IDIOPATHIC PULMONARY FIBROSIS (IPF)
Primary Investigator: Yolanda Mageto, M.D.
Coordinator: Patricia Lutton
Coming this summer
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
(COPD)
Forest: A 52-week, Double-Blind, Randomized, PlaceboControlled, Parallel-Group Study to Evaluate the Effect of
Roflumilast 500 μg on Exacerbation Rate in Subjects with
Chronic Obstructive Pulmonary Disease (COPD) Treated
with a Fixed-Dose Combination of Long-Acting Beta
Agonist and Inhaled Corticosteroid (LABA/ICS)
Primary Investigator: Anne Dixon, M.D.
Coordinator: Meena Subramanian
Who: People with COPD and Chronic Bronchitis
What: 8 visits over 1 year
Compensation: $50 per visit. Advair 250/50 or Symbicort 160/4.5
and Albuterol provided.
Study of the Effects of Education on Patients with COPD
Primary Investigator: David Kaminsky, M.D.
Coordinator: Joan Lippmann
Who: People with COPD
What: 7 visits over 12 weeks
Voucher-based incentives to promote smoking abstinence
among patients with chronic obstructive pulmonary
disease
Primary Investigator: Stacey Sigmon, Ph.D.
Co-Investigators: Anne Dixon, M.D., Charlotte Teneback, M.D.
Coordinator: Mollie Patrick
Who: Smokers who are over age 35 and have a diagnosis of COPD
What: 2-wk study with brief daily visits for monitoring smoking status
Compensation: Up to $587.50
CYSTIC FIBROSIS
A Phase 2, Multicenter, DoubleBlinded,
PlaceboControlled, 3-Part Study to Evaluate Safety,
Efficacy, Pharmacokinetics, and Pharmacodynamics of
VX661 Monotherapy and VX661/VX770 Cotherapy in
Subjects with Cystic Fibrosis, Homozygous for the
F508del-CFTR Mutation
Primary Investigators: Laurie Leclair MD /Thomas Lahiri MD
Coordinators: Joan Lippmann/Sandra Diehl
Who: People with Cystic Fibrosis
What: 9 visits over 2.5 month period including 28 days treatment
Compensation: Up to $1150
A Phase 3, Randomized, Double-Blind, Placebo-Controlled,
Multicenter Study of Aztreonam for Inhalation Solution
(AZLI) in a Continuous Alternating Therapy (CAT)
Regimen of Inhaled Antibiotics for the Treatment of
Chronic Pulmonary Pseudomonas aeruginosa Infection in
Subjects with Cystic Fibrosis
Primary Investigator: Laurie Leclair, M.D.
Coordinator: Sandra Diehl
Who: People with Cystic Fibrosis
What: 9 visits over 8.5 month period including 6 months treatment
Compensation: Up to $675
A phase 2, Randomized Double-blind, Placebo-controlled,
Repeat-dose study of KB001-A in Subjects with Cystic
Fibrosis Infected with Pseudomonas aeruginosa
Primary Investigator: Laurie Leclair, M.D.
Coordinator: Joan Lippmann
Who: People with Cystic Fibrosis
What: 9 visits over 8.5 month period including 6 months treatment
Compensation: Up to $675
WWW.VERMONTLUNG.ORG
The Vermont Lung Center
The University of Vermont
Medical Of;ice Bldg., Suite 305
792 College Parkway
Colchester VT 05446
Non-­‐Profit Org.
U.S. Postage
PAID
Permit No. 143
Burlington, VT
SPRING 2013
The Vermont Lung Center is affiliated with the following organizations:
The Vermont Lung Center is
supported in part by the
following organizations:
Smokers with asthma needed…
You may be eligible to participate
in a research study
Are you between the ages of 18 to 50?
Do you have physician-diagnosed asthma?
Do you smoke at least five cigarettes per day?
Participants will be compensated
Call the Vermont Lung Center 847-8839